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Medical Record Review
Physician-led review of medical records and documentation relevant to healthcare disputes, investigations or litigation.
LITIGATION & LEGAL SUPPORT
Clinical and Coding Expertise for Complex Legal Matters.
Healthcare disputes often involve questions surrounding medical records, clinical documentation, coding, billing, reimbursement and regulatory requirements. Dr. Sloan-Kelly Consulting provides physician-led consulting support to attorneys, healthcare organizations and other parties who need these issues evaluated through both a clinical and coding lens.
Request a Legal ConsultationTHE RECORD AS EVIDENCE
Understanding What the Record Actually Supports
Medical records can be clinically complex and technically difficult to interpret outside the context in which care was delivered.
DSKC helps legal teams understand the relationship between the clinical record, documented services, coding, billing and reimbursement. Our physician-led perspective can help identify what the documentation supports, where inconsistencies exist and which issues warrant deeper analysis.
WHAT WE CAN ASSIST WITH
What We Can Assist With
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Coding & Billing Analysis
Evaluate coding, billing and documentation issues to determine whether reported services are supported by the available record.
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Documentation Analysis
Assess the clinical record for documentation patterns, inconsistencies, omissions and issues relevant to the matter under review.
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Reimbursement & Claims Analysis
Evaluate healthcare claims, reimbursement issues and the relationship between documentation, coding and payment.
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Compliance & Regulatory Analysis
Provide subject-matter analysis of healthcare coding, documentation and compliance issues relevant to a legal or investigative matter.
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Attorney & Litigation Support
Help counsel understand complex clinical, coding and reimbursement concepts and identify issues requiring further investigation or expert analysis.
PHYSICIAN + CODING PERSPECTIVE
The Clinical Story and the Coding Story Should Make Sense Together.
A code cannot always be evaluated appropriately without understanding the clinical circumstances behind it. Likewise, the medical record may require coding expertise to understand how documented services ultimately became claims.
Dr. Sloan-Kelly brings physician training together with professional coding expertise to evaluate both sides of that relationship.
This perspective can be particularly valuable when a matter involves questions about whether documentation supports reported services, whether coding accurately reflects the record or how clinical documentation affects reimbursement.
TYPES OF MATTERS
Support Across Healthcare Legal and Investigative Matters
Depending on the scope of the engagement, DSKC may provide consulting support involving:
- Coding and billing disputes
- Medical record and documentation review
- Healthcare reimbursement disputes
- Audit and investigation support
- Compliance-related matters
- Claims analysis
- Physician documentation issues
- Pre-litigation case assessment
- Attorney education regarding clinical and coding issues
- Other matters requiring combined physician and coding expertise
CUSTOM ENGAGEMENTS
Every Matter Requires Its Own Scope.
Legal and investigative engagements vary significantly in complexity, record volume and the level of analysis required.
DSKC evaluates each matter individually and develops an appropriate scope based on the records, questions presented and requested services.
Related DSKC services: Medical Coding Audits, Coding & Documentation, Revenue Integrity & Reimbursement and Compliance Programs & Plans. Have a broader question? Contact DSKC.
Dr. Sloan-Kelly Consulting provides healthcare consulting and subject-matter expertise and does not provide legal advice or legal representation.